Localized vitiligo, where the white patches are limited to one or a few areas of the body, can be managed with a few treatment approaches. The best therapy usually depends on the extent of the vitiligo, its location, the patient's age, and their personal preference. Here are a few treatment options that are commonly used:

• Topical corticosteroids: These are often the first choice for treating localized vitiligo. They can stimulate the melanocytes (pigment-producing cells) to regenerate and reproduce the skin color. However, they must be used under a physician's guidance due to potential side effects, such as skin thinning.
• Topical calcineurin inhibitors: These are creams or ointments like tacrolimus or pimecrolimus, which are non-steroidal and can be used on sensitive areas such as the face. They are particularly useful when topical steroids might be unsafe, such as on areas of thin skin or in children.
• Excimer laser: This laser treatment uses a specific wavelength of UVB light and is often used for localized vitiligo, particularly when it affects the face or neck. It's often well-tolerated and can lead to significant re-pigmentation.
• Surgical therapies: Methods such as melanocyte-keratinocyte transplantation (MKTP) or punch grafting can be used when other treatments are not successful. These methods involve transplanting melanocytes from unaffected areas to the white patches. However, this is usually considered only for patients whose disease has been stable for at least 6 months to 1 year and who do not respond to other treatments.

A recent investigation cites early systemic immunomodulation for recent localized vitiligo as a “successful approach” for achieving early control of disease activity:

• Disease activity is arrested following an average 4 months of treatment.
• Patients achieve complete repigmentation in a mean span of 7 months.
• Recurrence is seen in 32% of patients at the end of the 4-year follow up.

It's always best to consult with a dermatologist to understand the best therapy for your individual situation, as they will be able to assess the skin condition and decide on the best course of treatment.